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Hypopnea's
#11
When are your hypopneas occurring? I get a big lot of hypos during the ramp period but these stop once it gets up to pressure. I just ignore these.
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#12
(06-26-2014, 05:36 AM)readyforsleep Wrote: Would love to hear your ideas, Robin
I'd need to see some data. The Events chart and Flow Rate from a typical good night and a typical bad night. The Pressure curve might also be useful.

If it were happening once or twice a month, I'd say it's just the random bad night, possibly caused by a visit from the aliens ....

You say it's about once a week. Is it always on the same day? Or same kind of day? In other words, is it usually on a weekday vs weekend?
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#13
Thank you guys. I'm in the middle of something right now, but will get the data together later this afternoon. You guys are great!
2010 sleep study 63 AHI, 2014 3.0
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#14
Often it is machine error. Watch Lanky Lefty's video.
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#15
All, here is my data from a good day and a bad day.

Lukie, still lookingnfor Lefty's video.
2010 sleep study 63 AHI, 2014 3.0
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#16
Wow Sleepy, your pressure sure stays on the top, doesn't it?

Your apnea's are obstructive for the most part, not central. So that I think is good.

So the question is why do you need such a top end pressure?

Back sleeping? I imagine this has all been discussed, but should probably be reviewed some more. I'm a big fan of back sleeping but for some of us that doesn't work too well. So if that's the case with you, try to avoid it.

The other thing I would do is get some elevation to your top side. Do something to prop up the head of your mattress, sleep in a reclining chair for awhile, or something to see if that helps reduce the obstructives.

Finally I know you have discussed your mask before, but I think it should be considered again. I'm not convinced the full face mask works as well as the alternatives in many cases. So re-evaluate your thoughts towards a nasal or pillows mask. Just saying "tried it" doesn't really work when you talk about a mask. You have to actually work with it for a period of days before discarding it.

But you're getting there. Maybe a little at a time, but getting there none the less. Good work keeping this going!
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#17
ahi is useless, drag that chart down out of the way or turn it off (your choice).

charts to show are events, flow, pressure and leak, at minimum. you can resize the charts and set their upper and lower limits in the preferences menu, also.
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#18
(06-26-2014, 03:14 PM)retired_guy Wrote: Finally I know you have discussed your mask before, but I think it should be considered again. I'm not convinced the full face mask works as well as the alternatives in many cases. So re-evaluate your thoughts towards a nasal or pillows mask. Just saying "tried it" doesn't really work when you talk about a mask. You have to actually work with it for a period of days before discarding it.

Retired guy, I love the nasal pillows. I have used them since 2010 with taping. Chin straps do nothing for me. I just switched to a ff mask this past May. I have had it
with taping.

RobySue, when I first trialed an autoset, I was using nasal pillows and my
pressure average was 16. This was with a Phillips Respironics machine. This
is the data point my doctor used to set my pressure at 11-20. Once I started using
a full face mask + s9 autoset my pressure needs increased
2010 sleep study 63 AHI, 2014 3.0
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#19
(06-26-2014, 03:14 PM)retired_guy Wrote: Wow Sleepy, your pressure sure stays on the top, doesn't it?

Your apnea's are obstructive for the most part, not central. So that I think is good.

So the question is why do you need such a top end pressure?
My take?

One of three things is likely happening:

1) You really do need more pressure than the max of 20cm to keep your airway open during (presumably) supine or REM or supine-REM sleep, and your current machine can't deliver that much pressure. In which case you need to either learn to stay off back or you need to talk to your sleep doc about being switched to a bi-level that can go up to 25cm if necessary.

2) Your min pressure is not set high enough and once the events start happening on a bad night, the rapid increase in pressure (9cm in 10-12 minutes) does not allow the airway to have a chance to stabilize. And the unstable airway leads to additional events being scored and the machine becomes very reluctant to reduce the pressure. You can test this hypothesis by increasing the min pressure to something a lot closer to 20. But I'd also advise you not to make the change in min pressure in one big jump. But it may very well be worth increasing the min pressure by 1-2cm and leave it there for 3-4 days before increasing the min pressure again. The goal is to find the lowest min pressure that prevents most of your events from happening in the first place so that the machine is not so prone to quickly jacking up the pressure when the events start.

3) Those aren't OAs at all, but rather they're mis-scored CAs. The Resmed FOT algorithm for detecting CAs is not infallible, and as the pressure goes up, the chances that a CA will be mis-scored as an OA also increase. In this case, that drastic 9cm jump in pressure that occurs in about 10-12 minutes may be triggering a CO2 overshoot/undershoot cycle, but because of the high pressure, the FOT mis-scores the CAs as OAs. And, of course, the fact that the machine is scoring them as OAs means the machine is less likely to reduce the pressure and let the breathing stablize. If this is what's happening on the bad nights, then you really need to get the sleep doc involved in figuring out where to go from here. A change in the APAP range might help; or not. A change to bi-level might help; or not.

In my opinion, it's worth consulting your sleep doc and showing him the data and asking him for his opinion about whether a bi-level is called for.
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#20
can we get a zoomed in view from about 23:01-23:06 on the chart from the 25th?
events, flow, pressure and leak strips please!
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